Provider Demographics
NPI:1790421816
Name:SNYDER, ALIA MORGAN (MS, RDN, CDCES)
Entity Type:Individual
Prefix:MRS
First Name:ALIA
Middle Name:MORGAN
Last Name:SNYDER
Suffix:
Gender:F
Credentials:MS, RDN, CDCES
Other - Prefix:
Other - First Name:ALIA
Other - Middle Name:MORGAN
Other - Last Name:BURLEW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1863 DOTY HILL RD
Mailing Address - Street 2:
Mailing Address - City:GILLETT
Mailing Address - State:PA
Mailing Address - Zip Code:16925-9210
Mailing Address - Country:US
Mailing Address - Phone:607-483-5939
Mailing Address - Fax:
Practice Address - Street 1:200 E CHURCH ST
Practice Address - Street 2:RM 221
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901-2752
Practice Address - Country:US
Practice Address - Phone:607-483-5939
Practice Address - Fax:866-439-9883
Is Sole Proprietor?:No
Enumeration Date:2022-05-11
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009524133V00000X
PADN007674133V00000X
NCL006951133V00000X
TN4288133V00000X
86047627133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered